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> how is it justified to keep access to life saving drugs beyond the reach of most people

Trivially. By asserting that without intellectual property protection those drugs wouldn't have been invented. I'm not arguing if that's true or not. But it's certainly how people justify it.

I'm going to copy and paste one of my favorite comments on copyright. From Judge Richard Posner. It's bit a of a wall of text; sorry. It's worth reading in it's entirety.

"A distinguishing characteristic of intellectual property is its "public good" aspect. While the cost of creating a work subject to copyright protection—for example, a book, movie, song, ballet, lithograph, map, business directory, or computer software program—is often high, the cost of reproducing the work, whether by the creator or by those to whom he has made it available, is often low. And once copies are available to others, it is often inexpensive for these users to make additional copies. If the copies made by the creator of the work are priced at or close to marginal cost, others may be discouraged from making copies, but the creator’s total revenues may not be sufficient to cover the cost of creating the work. Copyright protection—the right of the copyright’s owner to prevent others from making copies—trades off the costs of limiting access to a work against the benefits of providing incentives to create the work in the first place.

STRIKING THE CORRECT BALANCE BETWEEN ACCESS AND INCENTIVES IS THE CENTRAL PROBLEM IN COPYRIGHT LAW. [empaphsis added]

For copyright law to promote economic efficiency, its principal legal doctrines must, at least approximately, maximize the benefits from creating additional works minus both the losses from limiting access and the costs of administering copyright protection."

http://cyber.law.harvard.edu/IPCoop/89land1.html

One may argue that balance is way off right now. I would prefer to see a system in which there are lump sums by the government for a treatment development with certain performance characteristics.

And the government owns the rights afterwards. We should make pharma companies do work for hire.

>Trivially. By asserting that without intellectual property protection those drugs wouldn't have been invented

That isn't trivial. It's stupid. It's a completely non-disprovable argument.

Plenty of innovations are created where creators voluntarily yields their rights and plenty of others are probably not created because the creator of it (under employment) isn't hugely keen on creating yet more property for his or her employer to exploit.

hahahaha this place is going downhill. In fairness, maybe it's always been like this during the too-early/way-too-late timeframes.

Sorry, but the world ain't full of copyleft warriors. People put their name on patents, in no small part because they immediately subsequently put that patent on their resumes. Nobody is denying themselves earning power - cash money - in order to protect the public interest from their big bad provider of paychecks. Especially since the public interest, here, means "the companies competing with my provider of paychecks".

>Sorry, but the world ain't full of copyleft warriors

Linux is the most popular operating system. A legal ideology that presumes that could never happen is simply wrong.

Does it cost a billion dollars to bring a new flavor of Linux to market?

http://www.scientificamerican.com/article/cost-to-develop-ne...

The issue is that with medicine, it cost vast amounts of money to develop and test a medicine. If there was nothing making sure the investment would pay of, there would be much less money spent developing medicine.

I am not saying the system is perfect, and some companies push the prices to the ridiculous to exploit people in need, but removing medical patents altogether would require some other equally strong economic incentive to keep development rolling.

I think you're missing the point on both the money and the patent laws in India. According to the article "Successive governments have taken a view that patents should be granted only for major innovations, not updates to existing compounds — allowing domestic manufacturers to make generic versions of drugs at vastly lower cost." - which basically means you get a patent for real innovation, not minor cosmetic changes to keep your cash flow going.

The second - "Pharmaceutical firms say India’s disregard for patents will stifle innovation or make drugs commercially unfeasible — Gilead paid $11 billion to buy the developer of Sovaldi in 2012."

Note that it didn't cost $11B to research the drug but what it cost to buy the company. It is disingenuous to claim that their R&D cost is that high.

Not sure how much it cost to develop Sovaldi, but in general it costs $1-2Bn and ~10-12 years to develop a drug and only 1% of drugs in pipeline actually reach the market. So $11b seems a reasonable cost to assume.

That $1-2 billion figure pharmaceutical companies like to throw out is the risk adjusted cost, which includes all of the failed drugs and clinical trials for each successful product. The acquisition price for Pharmasset included Sovaldi and several other drugs.

> The issue is that with medicine, it cost vast amounts of money to develop and test a medicine.

If that is the real issue, then subsidize the costs of clinical research, instead of accepting that everyone pays the price of drugs 10 times what they should cost.

There's an international co-ordination problem there. National governments don't want to foot the bill for research that the whole world needs.

So instead nations still foot the bill for research. The draconian US patent system proportedly produces more drug R&D than elsewhere, but where are those patents applicable?

The US, and anyone agreeing to honor its patents.

Everyone else gets free drug R&D without anything close to international discourse on funding drug research, because its privatized and thus in the scope of trade law.

Even better, the drug patent system means novel treatments are being developed for life threatening conditions that the suffers are disproportionately unlikely to be able to afford ("The Sick", as a demographic, are much poorer than average for obvious reasons). So not only are you subsidizing global drug research, you are doing it on the backs of the poor.

You can make an international body (or use the WHO) to fund such clinical trials then. It's not like we lack global organizations either.

UN budget around 5.5bn$ for two years, WHO around 4bn$. Not enough by a long way if drugs are costing 1-2bn$ to develop.

That kind of command and control economy was tried in many countries (the whole Soviet block) and pretty much failed spectacularly every single time.

The prices pharma companies ask for is ridiculous and makes the drug unavailable to 90% of the people that need it.

if they priced their drug to make it more accessible they could easily make the development cost back by making money off the 90% they left to die or hunt for drugs on the Indian market.

There needs to be a balance between getting drugs to the people that need it and making a profit. Currently that balance is non existent and pharma companies charge ridiculous amounts knowing full well that us insurance companies will pay it.

You know how the rest of the planet feels when your insurance company refuses to pay for your drugs and you have to pay for it yourself.

I wouldn't be so sure about it. 8 years ago my dad was diagnosed with GIST, for which there was only one drug at the time - Glivec made by Novartis. He had to take 2 boxes a month, each one costing 5x the average national montly salary. Fortunately, the national health insurance in Poland covered the cost of the drug fully, so he never paid anything for it.

The point I am trying to make is that when he was diagnosed, there was 6 other people in Poland who have been diagnosed with the exact same type of cancer. By the time he died last year(thanks to Glivec he lived much longer than the original predicted 6-12 months with traditional chemotherapy) the total number of people with GIST in Poland taking Glivec was 30-40. That's in a country with 40 million citizens.

So sure, the drug is not affordable to pretty much anyone in Poland, if the national insurance wasn't paying for it. But even if it wasn't ultra-expensive, there still a very limited number of people who need it, so I can see why Novartis charges what they do to make at least some money back.

I doubt the insurance was actually paying the sticker price on that medicine anyway. It's all part of the illusion.

It's nationalised insurance. They don't need to mislead you to convince you there is a value in the service they provide. Since it's government the information is public. For example, when I buy medicine in France (also nationalised) it shows how much I pay and how much the government pays. So yes, they are paying whatever the receipt says.

If this is true, that is awful. That means nations are lining drug companies coffers for profit rather than just doing the research themselves and selling the fruits of research at the cost of manufacturing rather than arbitrarily insane prices due to state guaranteed monopolies.

No, the state negotiates as low price as possible because the national health service is given a certain budget that they have to fit in. The difference here is that in US your insurance company might say that they will pay 50% and you have to pay the remaining 50%. In Poland the national health service would never offer you such a deal. Either it's fully covered or it's not offered at all. Therefore companies are willing to lower their prices so that the government accepts their medicine at all, rather than having it rejected and not offered at any of the hospitals.

And the last time I checked the treatment with Glivec is a lot more expensive in US than it is here, so this system must be working at least partially.

Would you invest your money in a pharma company that returned below-the-market risk-adjusted returns?

No because the market is part of the problem. I would however invest (read as donate) in a non profit pharma with the sole goal of developing drugs and covering their development cost.

You can do that already, just donate to universities and public research institutions doing drug research.

Now, do you think that investors should be forced to invest in pharma companies offering lower-than-market returns?

We already have publicly funded research, which is an altogether more effective way of developing new medicines anyway.

Developing the actual therapeutic is a very different endeavor, not one that academic institutions are well set up for. You need to do pre-clinical studies on efficacy and toxicity, modify your drug to make sure your animal models work, then scale that to humans including engineering the right delivery format, dosage, etc. that process for the most part is inefficient, expensive, and has a high rate of failure.

> which is an altogether more effective way of developing new medicines anyway

I would like to believe that, but have you got any data to back this point? How many new medicines are developed by public research?

See the downvoted answer below for citations.

Nonsense, disregarding the pink elephant in the room (reproducibility in academia) once a method has shown potential it is often spun off into some sort startup (often SBR recipients). If they keep gaining clout, a bigger pharmaceutical will buy them out. New medicines are developed 10% by a university and 90% by industry.

And the university likely pockets a nice little "non-profit"

Not 90%. 58%. According to JAMA.

https://jama.jamanetwork.com/article.aspx?articleid=185198

When the public funds drug research it also doesn't "magically" discover that its drugs are really effective when they aren't:

http://articles.mercola.com/sites/articles/archive/2006/06/1...

Actually when the public funds drug research it's often not reproducible 1. From personal experience the number of times when the work isn't a fabrication is less than the number of fingers on my right hand.

1 http://blog.scienceexchange.com/2012/04/the-need-for-reprodu...

You're seriously going to post Mercola on HN?

Yes, go ahead and down vote me for flagging links to a quack's website.

Please don't post comments about getting downvoted: https://news.ycombinator.com/newsguidelines.html

The comment was unsubstantive and dismissive. If there's something wrong with a source, it would be better to explain what that is instead of just snarking, which (a) undermines civility and (b) teaches us nothing.

Very well. Joseph Mercola[1] to put it politely, is not burdened by objective reproduction of claimed results when hawking his alternative remedies.

[1] https://en.wikipedia.org/wiki/Joseph_Mercola

If you're going to disagree with the source, disagree with the source, not the website that cited the source:

"Researchers from the Beth Israel Medical Center in New York City examined four journals: American Journal of Psychiatry, Archives of General Psychiatry, Journal of Clinical Psychiatry and Journal of Clinical Psychopharmacology. They found drugs were favored in roughly:"

Is Beth Israel full of quacks?

I doubt it, but since Mercola didn't link me to their meta-study I can't find the reference directly. It's not the JAMA link that was in the OP.

> I find the concept of intellectual property and patents ridiculous.

I think what's more ridiculous is that the patent system was not made, in the first place, to lock competition out of the market. It was supposed to be a starting point to create licenses for other companies to produce the same item, by providing royalty fees to the original patent owner.

But the system has quickly become a way to create rents and lock competitors out of the market. Short of fixing patents by making them shorter and all, we should find a way to market licenses at reasonable costs so that alternatives exist even during patent protection.

This should be a HN FAQ because every time the topic comes up, someone makes your invalid argument. Well, it's not really an argument but more of the sympathy card.

It cost billions to develop a drug and pennies to make it. Can you explain the business model where companies don't go out of business and research dries up? India is creating drug resistant bacteria because antibiotics are so overused.

http://www.nytimes.com/2014/12/04/world/asia/superbugs-kill-...

Who's going to pay for the research needed to prevent a pandemic?

I'm going to write a blog so this question doesn't need to be answered every couple of months.

How about India with a million people turning 18 every month (https://news.ycombinator.com/item?id=11232383), develop a drug industry to create better and cheaper new drugs, while creating great jobs for people who need them?

Of course, if you simply give away everyone's work, no company is going to stay in business.

My point was that innovation and financial reward need to be decoupled to ensure valuable knowledge is not locked behind IP.

> Of course, if you simply give away everyone's work, no company is going to stay in business.

To think about a future without ridiculous restrictions on access to knowledge(which IP law promotes implicitly), it is important to stop accepting the status quo in which innovation and financial reward are directly linked.

You seem to accept the reality that innovation has to be linked to financial reward by gaining exclusive rights over the invention using IP laws,which,respectfully,is preposterous.

Can you provide some concrete examples of the business model, and how it works? Perhaps some new agile startups could disrupt big pharma.

You can't realistically expect people to accept that you have a better plan without offering real evidence that it works.

I don't claim to have a magical solution for the problems but what I can do is get people talking about the current system and potential solutions. Isn't that the first step towards solving any problem?

I plan to share some of my thoughts and potential solutions in a blog post, and I will be sure to share it here.

> Who's going to pay for the research needed to prevent a pandemic?

Actually given that this is a real threat, someone will. Even if only to save themselves.

And because they'd have extreme problems if they saved only themselves, rather than the entire civilization supporting them, they'll make it available to others too.

Yes this is hardball negotiating 101 : if doing something solves a strategic risk for someone, don't pay them a dime to do it. You may even consider making it more expensive for them to do, if that provides you with an advantage.

Might be unrelated to the topic but I don't understand how you came up with the summation "India is creating a drug resistant bacteria because antibiotics are overused" from that nytimes article. The same article also mentions that the overuse of antibiotics in US factory farms has also lead to outbreaks of drug-resistant diseases in recent years. Yes it mentions that there's been a clampdown from 2000 to 2010, but I am skeptical of accepting this fact without numbers. Can I go ahead and say that US will be responsible for creating drug resistant bacteria?

You may not know this, but one of the major outbreaks of drug-resistant superbugs is because of Indian drug manufacturers exploiting lax environmental laws to dump anti-bacterial refuse into village waterways. A large number of these manufacturers are contracted by US big pharma because it is much cheaper to produce (even patent-protected) drugs in India. If you're interested, here's the bad medicine report on it https://s3.amazonaws.com/s3.sumofus.org/images/BAD_MEDICINE_....

My point is no one country or entity can be blamed for the rise of superbugs. The problem is systemic and it needs us to step out of our reductionist paradigm to solve it.

> Except the corporation or inventor(s) making money off of it, I can't think of anything significant.

But, that alone is significant enough to justify most intellectual property: patents, copyright, etc. But, it's not nearly enough to justify a patent system that allows you to patent absolutely obvious bullshit then turn around and sue everyone. And, it doesn't justify our copyright system either, with insane terms which span centuries.

So I would agree that it's an open question whether the way we do intellectual property now is better than absolutely nothing i.e. everything publicly known is automatically public domain. I suspect we'd be better off with no patents and no copyright, than with what we have now. But intellectual property in theory and properly implemented, is unquestionably a fine idea, and obviously far superior both to the shit show we have now, and also to a Wild West approach.

Anyway, it's not like you need patents to gouge patients cf epipen, insulin, where patents ran out decades ago and yet, strangely, stuff that costs a few dollars to actually make, is priced in the hundreds of dollars.

> But, that alone is significant enough to justify most intellectual property: patents, copyright, etc.

No, certainly not. Guaranteeing corporate profits are never a justifiable reason to restrict freedom of information so severely.

You do not need a patent on plastic forks to make money selling them. If there is demand, the floating price will be above the price of manufacture, and the economy is incentivized to meet that demand. If drug recipes were not patented, and there was demand for a drug, once the profit overcomes opportunity cost everyone in industry has incentive to start meeting the demand.

Plenty of arguments exist in this thread why you do not need private for-profit research to discover medicine - and why in many ways having such a system is counter-productive in the first place (the industry consistently refuses to consider anything as a product they cannot patent - and will actively harm people by not selling products they know work but that they cannot guarantee long-term monopoly on).

Yes, certainly. And OP said corporation or inventor.

As long as we're doing capitalism, we ought to have a way for people to make a living off of knowledge work and the arts. Not selling physical artifacts of knowledge work, or making some sort of other derivative income off of it, but profiting directly from the generation and POC of good ideas. It is a system that served us well for one hundred years or more before being hijacked by a pack of ruthless jackals - I probably agree that if we can't fix it it's better to tear it down, but we should still try to fix it.